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State Program Management Unit-NHM District: Tehri 2020-21

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State Program Management Unit-NHM District: Tehri 2020-21 State Program Management Unit-NHM RECORD OF PROCEEDING (RoP) UTTARAKHAND District: Tehri 2020-21 NATIONAL HEALTH MISSION District Tehri RoP 2020-21 Chapter Name of Programme Approval in Number lakhs 1 Maternal Health 115.34 2 Child health 28.91 3 Family planning 46.26 4 RKSK 103.54 5 RBSk plus Haemoglobinopathy 61.33 6 PCPNDT 1.55 7 Human Resource ( Programme Management HR , mobility and service delivery HR) 790.77 8 Immunization 77.95 9 ASHA 210.14 10 Untied fund 148.88 11 Health and Wellness Centres 111.2 12 Infrastructure and civil works 11.28 13 IEC 24.77 14 Quality Asssurance and Kayakalp 4.00 15 HMIS 10.42 16 Free drug Programme 00 17 Free diagnostic Programme 00 18 Blood services 00 Tehri District RoP 2020-21 Page 1 19 IDSP 18.36 20 NVBDCP 4.67 National Viral hepatitis control programme 0.55 National Programme for Climate Change and 21 Human Health 1.49 National Rabies Control Program 22 1.30 23 NLEP 6.48 24 RNTCP 80.85 25 NCD National Programme for Prevention and Control of 23.50 Cancer, Diabetes, Cardiovascular Diseases and Stroke NPCDCS National Tobacco Control Programme 9.13 National Programme for Control of Blindness and 38.26 Visual Imapirement (NPCB& VI) National Mental Health programme (NMHP) 2.72 National Programme for the Healthcare of the 4.20 Elderly (NPHCE) National Oral health programme (NOHP) 8.10 National Programme for Prevention and Control 0.20 of Deafness (NPPCD) National Programme for Palliative Care (NPPC) 0.60 Pradhan Mantri National Dialysis Program 0 (PMNDP) National Iodine Deficiency Disorders Control 0.61 Program 1947.34 Total 122.86 Committed 2070.20 Grand Total Tehri District RoP 2020-21 Page 2 RoP Conditionalities 1. The support under NHM is intended to supplement and support, and not to substitute state expenditure. All the support for HR will be to the extent of positions engaged over and above the regular position as per IPHS and case load. NHM aims to strengthen health systems by supplementing, and hence it should not be used to substitute regular HR. All states are encouraged to create sanctioned regular positions as per their IPHS requirement. HR should only be engaged when infrastructure, procurement of equipment etc. required to operationalize the facility in place. 2. Action on the following issues would be looked at while considering the release of funds: District has to ensure the timely Submission of Monthly FMR (Financial Management Report) & SoFP (Statement of Fund Position) as per New FMR format on Monthly basis by 7th of following month mandatorily. After completion of the financial year 2020- 21, Districts must submit their provisional Balance Sheet including all Annexures with Utilization certificate to State Health Society by 15th April 2021. Submission of the Statutory Audited Balance Sheet for the FY 2019-20 with All Annexures including Utilization Certificate (As per 12-C Format). District must ensure to open accounts of all agencies in PFMS and also ensure expenditure capturing, State have already given the training to all districts officers/concerned Accounts staff District has to ensure to clear all “Advance Under Review” pendency. Ensure timely action for engagement of CA Firms as Monthly Concurrent Auditors for NHM Audit at their district for the FY 2019-20 & also submit the Monthly Concurrent Audit Report to State Health Society on Monthly basis by 15th of the following Month . All approvals are subject to the framework for Implementation of NHM and guidelines issued from time to time and the observations made in this document. The Record of Proceedings (RoP) document conveys the summary of approvals accorded by NPCC based on the State/Districts PIP/RoP. District should maintain their programme accounts of NHM as per Operational Guidelines for Financial Management Manual. Finance District should convey the Block wise approvals within 15 days of receiving the District RoP approvals and also submit a copy to State Health Society. All funds under NHM will be released from State Health Society to DHFWS in a pool , not activity wise or FMR Code wise. Districts are entitled to use these funds on need basis by allocating internally the funds from one pool to another pool in case of shortage of fund in a particular pool but activity must be approved from GoI and the proposed expenditure should not cross the approved limit under any FMR Code as given in District RoP. DHFWS should also communicate State Health Society about details of fund allocated from one pool to another pool at the end of each month along with FMR / SoFP. The District must ensure due diligence in expenditure and observe, in letter and spirit, all rules, regulation, and procedure to maintain financial discipline and integrity particularly with regard to procurement; competitive bidding must be ensured, and only need- based procurement should take place. Tehri District RoP 2020-21 Page 3 All procurement to be based on competitive and transparent bidding process. The unit cost/rate approved for all activities including procurement, printing, etc are indicative for purpose of estimation. However, actual are subject to transparent and open bidding process as per the relevant and extant purchase rules/ Uttarakhand Procurement Rules 2017 (revised). Third party monitoring of works and certification of their completion through reputed institutions will be introduced by SHS to ensure quality. In addition, information on all ongoing works to be shared with State for displaying it further on the State NHM website District has to ensure regular meetings of District Health Mission/ Society. The performance of DHS along with financials audit report must be tabled in meetings of DHFWS as well as District Health Mission’s meetings. The accounts of District Health Society shall be open to inspection by the sanctioning authority and audit by the Comptroller & Auditor General of India under the provisions of CAG (DCP) Act 1971 and internal audit by Principal Accounts Officer of the Ministry of Health & Family Welfare/ GoI. District shall ensure submission of details of unspent balance indication inter alia, funds released in advances & funds available under District Health Societies. The district shall also intimate the interest amount earned on unspent balance. This amount can be spent against approved activities. Every district has to ensure timely renewal of registration of their DHFWS. In case of non- compliance, State would not be in the position to release funds to the concerned DHFWS. Tehri District RoP 2020-21 Page 4 Chapter 1 Maternal Health Maternal and Child Health program Health been designed and developed as an innovative and integrated approach for improving RMNCH+A Health Outcomes. The initiative has been built upon both Community & Facility Level Interventions with focus on improving both demand and delivery of services & for ensuring Respectful & Quality Care across all levels. Successful implementation of the initiative would lead to decrease in Maternal & Newborn Mortality in the State. AIM: Achieving Positive Pregnancy Experience & Outcomes. Primary Objectives: 1) Delivery of Respectful & Quality Care for, a) Better Antenatal (ANC) Services during pregnancy b) Better Care around Birth (Delivery) Services c) Better Postnatal (PNC) Services during post delivery period 2) Strengthen Maternal & Neonatal Death Surveillance & Response System STATE GOALS: Immediate Goals: To be achieved by 2020-21 - Number of 4 ANC Visits are to be increased 2.5 times of current coverage ie from current 31% (NFHS-4:2015-16) to more than 75% of all ANC. - Number of Full ANC coverage is to be increased 3 times of current coverage ie from current 12% (NFHS-4:2015-16) to more than 50% of all ANC. - Number of 1st trimester ANC Visits are to be increased from current 61% (HMIS 2017-18) to more than 90% of all ANC. - Number of High Risk Pregnancy Detection is to be increased 4 times of current coverage ie from current rates of 1% (MCTS:2016-17) to > 4% - Achieve Birth Planning rates of greater than 80% - Increase Institutional Delivery rates from 69% (NFHS-4:2015-16) to > 85% - Increase Safe Delivery Rates from current 73% (NFHS-4:2015-16) to > 90% - Bring Home Delivery Rates to single digits (less than 10%) across all Blocks - Improve Access to Delivery Points (DP’s) and 2 times availability of DP’s at PHC level from current 35% to > 70% Long Term Goals: To be achieved before 2025-26 - Achieve Sustainable Developmental Goals for Maternal & Newborn Health by year 2025- 26; five years before the expected timelines in 2030. Maternal Mortality Ratio (MMR) – Below 70 per 1 lakh live births . Neonatal Mortality Rate (NMR) – Below 12 per one thousand live births PRIORITY INTERVENTIONS: 1) Organize Fixed ANC & PNC Service Day (Samman Divas) at Sub-Center Level every Monday Tehri District RoP 2020-21 Page 5 2) Focus on ANC Counselling&Birth Planning and use of ANC Counselling & Training Wall & Birth Plan cards. 3) Conduct Facility Level Emergency Drills in the Labor Room every week. 4) Track and ensure availability of Key commodities as listed in GOI RMNCH+A 5x5 Matrix. 5) Ensure regular Online Data Reporting on Samman portal, SNCU Online and PMSMA Portal. Use of Scorecards for recognizing Health Providers & Teams and address gaps. 6) Organizing Quarterly Review & Facilitation Event at District level EXPECTATIONS: 1) Improve Demand for Institutional Deliveries, 2) Improve Access to Delivery Points based on Time to Care approach, 3) Better provisions, availability & development of Human Resource for Health a. Fill Vacant Sub Centers to achieve average Vacant Subcenter Rates below 2% to total Subcentres at any given point. b. Rationale case based deployment of HR at all levels. Calculate requirements for the Post of Specialists, Medical Officers, and Staff Nurses & ANM’s to below 2%.
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